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There are classes of medications that should be avoided in SPS, including serotonin-norepinephrine reuptake inhibitors (SNRIs; i.e, tricyclic antidepressants and duloxetine) and opioids. SNRIs have previously been shown to worsen the EMG activity and clinical symptoms in SPS. Opioids are not recommended for pain control because most individuals with SPS are on benzodiazepines. Mixing these two classes of medications can lead to severe respiratory depression and death.

It’s thought that Stiff Person Syndrome is caused by the immune system producing antibodies to a protein called GAD. GAD is necessary to synthesize GABA. GABA is necessary to control muscle movement and to inhibit excitability in the brain and spinal cord.

This means people with SPS will have rigid muscles and spasms. They will also find themselves working harder to inhibit emotional outbursts. They will startle in an obvious way, often experiencing stiffness or severe spasms in response to a stimulation that may almost go unnoticed, or at least rapidly accommodated to by others.

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Most, but not all, of patients with Stiff Person Syndrome have elevated GAD65 levels in the blood indicates that the body is creating an antibody that attacks GAD, impairing the body’s ability to make GABA.

However, Some people with stiff person syndrome have antibodies to amphiphysin, which is a protein involved in the transmission of signals from one neuron to another. People with these antibodies have a higher risk for developing breast, lung, or colon cancer.

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5% of all SPS patients have the Paraneoplastic variant of Stiff Person Syndrome. For them, there are anti-amphiphysin and anti-gephyrin antibodies ),most commonly found in association with breast adenocarcinoma and small-cell lung carcinoma.

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